A PHB is a new way of meeting health needs that is highly responsive to individuals but respects the principles of the NHS that access to care is based on need and is free at the point of use. At its simplest, a PHB is an amount of NHS funding which is allocated to an individual to meet a health need that satisfies existing NHS criteria for support instead of receiving centrally commissioned services. The PHB allows individuals or their carers on their behalf to choose how best to meet their health needs. For example, Colin's family found that renting a flat and buying a Sky Plus box was a far more effective approach to managing their father Malcolm's behaviour, as his dementia progressed, than the NHS day service to which he had originally been referred. Since he was unhappy at the day service, his behaviour became worse. Soon, four staff were needed to manage him and his medication had to be increased. He is now on a third of the medication he was on then and on his lowest level since coming out of hospital four years ago. Malcolm's PHB has also enabled him to keep living at home four years after his family was told that he would never live at home again.

PHBs are not appropriate for all aspects of healthcare. In an emergency, few people want to make choices about their treatment.